The present invention relates to novel N-sulfamoyl-piperidineamides and their physiologically acceptable acid addition salts, to pharmaceutical compositions comprising them, processes for their preparation, and their use for the treatment of obesity and related conditions.
WO 03/088908 discloses N-sulfamoyl-piperidineamides with a specific substitution pattern at the piperidine ring. The compounds of WO03/088908 are assumedly useful for treating arrhythmia, IKur-associated conditions, gastrointensinal disorders, diabetes, cognitive disorders, and related conditions.
US2004/0167185 describes several N-sulfamoyl-piperidineamides in the area of treating or preventing cancer.
A method of discovering compounds suitable for the treatment and/or prophylaxis of obesity by inhibiting lipogenesis via the inhibition of carbonic anhydrases in mammals and humans is known from document WO 02/07821.
It was an object of the present invention to provide novel medicaments for the treatment and/or prophylaxis of obesity and its concomitant and/or secondary diseases or conditions, which are very effective and can be obtained in simple manner.
It has now surprisingly been found that certain novel N-sulfamoyl-piperidineamides and their physiologically acceptable acid addition salts are suitable for the treatment and/or prophylaxis of obesity and its concomitant and/or secondary diseases or conditions.
The invention is directed to compounds of Formula I,
wherein R1 is selected from the group consisting of H; alkyl; cycloalkyl; alkylenealkoxy; alkylenecycloalkyl; aryl unsubstituted or substituted by one or more alkyl, alkoxy, halogen, CF3, CN; alkylenearyl; alkylenearylenealkyl; alkylenearylenehalogen; alkylenearyleneoxyalkyl; alkylenearylenedialkylamin; heteroaryl; alkyleneheteroaryl unsubstituted or substituted with alkyl, alkoxy, halogen, CN, CF3;
wherein R2 is selected from the group consisting of cycloalkyl; aryl unsubstituted or substituted with alkyl, alkoxy, halogen, CN, CF3; alkylenearyl, unsubstituted or substituted, but not substituted by furan or furanyl; alkylenealkoxy; alkylenecycloalkyl; heteroaryl; CO-alkyl; CO-cycloalkyl; CO-aryl substituted by alkyl, alkoxy, halogen, CF3, CN; CO-alkylenearyl unsubstituted or substituted with alkyl, alkoxy, halogen, CF3, CN; CO-heteroaryl unsubstituted or substituted by alkyl, alkoxy, halogen, CF3, CN; CO—O-alkyl; CO—O-cycloalkyl; CO—O-aryl substituted with alkyl, alkoxy, halogen, CN, CF3; CO—O-alkylenearyl unsubstituted or substituted with alkyl, alkoxy, halogen, CN, CF3; CO—O-heteroaryl; CO—NH-alkyl; CO—NH-cycloalkyl; CO—NH-aryl substituted with alkyl, alkoxy, halogen, CN, CF3; CO—NH-alkylenearyl unsubstituted or substituted with alkyl, alkoxy, halogen, CN, CF3; CO—NH-heteroaryl; SO2—NH2; SO2-alkyl; SO2-aryl unsubstiuted or substituted by alkyl, alkoxy, halogen, CF3, CN;
or; wherein R1 and R2 together form a 5 or 6-membered ring which may optionally contain from 1 to 2 additional heteroatoms independently selected from the group consisting of nitrogen, oxygen and sulfur; and which may optionally bear 1 or 2 double bonds; and which may also be substituted by alkyl, halogenalkyl, aryl unsubstituted or substituted with alkyl, alkoxy, hydroxy, halogen, CN, CF3, and/or heteroaryl; and which may also contain a carbonyl group; and which may also be condensed with aryl;
wherein R3 and R4 are independently selected from the group consisting of H, alkyl, cycloalkyl, cycloalkyl containing 1 or more heteroatoms selected from nitrogen and oxygen; cycloalkyl containing 1 or more heteroatoms selected from nitrogen and oxygen, and optionally substituted with alkyl, alkoxy, halogen, CF3, CN; aryl; aryl substituted with alkyl, alkoxy, halogen, CF3, CN; heteroaryl unsubstiututed or substituted with alkyl, alkoxy, halogen, CF3, CN; alkylenearyl; or wherein R3 and R4 together form a 5 or 6-membered ring which may optionally contain from 1 to 2 heteroatoms independently selected from the group consisting of nitrogen and oxygen atoms and which may also be substituted by aryl or aryl substituted with alkyl, alkoxy, halogen, CF3 and CN;
and their physiologically acceptable acid addition salts.
Compounds of Formula I are suitable for the treatment and/or prophylaxis of glaucoma, epilepsy, bipolar disorders, migraine, neuropathic pain, obesity, type II diabetes, metabolic syndrome, alcohol dependence, and/or cancer, and its concomitant and/or secondary diseases or conditions in mammals and humans.
More specifically, in compounds of Formula I, R1 is selected from the group consisting of H; alkyl; cycloalkyl; alkylenealkoxy; alkylenecycloalkyl; aryl; alkylenearyl; heteroaryl; alkyleneheteroaryl unsubstituted or substituted with halogen; R2 is selected from the group consisting of cycloalkyl; aryl substituted with alkyl, alkoxy, halogen, CN, CF3; alkylenearyl, unsubstituted or substituted, but not substituted by furan or furanyl; alkylenealkoxy; alkylenecycloalkyl; CO-alkyl; CO-cycloalkyl; CO-alkylenearyl; CO-heteroaryl; CO—O-alkyl; CO—O-cycloalkyl; CO—O-aryl substituted with alkyl, alkoxy, halogen, CN, CF3; CO—O-alkylenearyl unsubstituted or substituted with alkyl, alkoxy, halogen, CN, CF3; CO—O-heteroaryl; CO—NH-aryl substituted with alkyl, alkoxy, halogen, CN, CF3; CO—NH-alkylenearyl unsubstituted or substituted with alkyl, alkoxy, halogen, CN, CF3; CO—NH-heteroaryl; SO2—NH2; or; R1 and R2 together form a 5 or 6-membered ring which may optionally contain from 1 to 2 heteroatoms independently selected from the group consisting of nitrogen, oxygen and sulfur; and which may optionally bear 1 or 2 double bonds; and which may also be substituted by alkyl, halogenalkyl, aryl unsubstituted or substituted with alkyl, alkoxy, hydroxy, halogen, CN, CF3, and/or heteroaryl; and which may also contain a carbonyl group; and which may also be condensed with aryl; R3 and R4 are independently selected from the group consisting of H, alkyl, cycloalkyl; or R3 and R4 together form a 5 or 6-membered ring which may optionally contain from 1 to 2 heteroatoms independently selected from the group consisting of nitrogen and oxygen atoms and which may also be substituted by aryl.
Even more specifically, in compounds of Formula I R1 is selected from the group consisting of H, alkyl; cycloalkyl; alkylenealkoxy; alkylenecycloalkyl; aryl; alkylenearyl; heteroaryl; alkyleneheteroaryl substituted with halogen; R2 is selected from the group consisting of alkylenealkoxy; alkylenecycloalkyl; CO-alkyl; CO-cycloalkyl; CO-alkylenearyl; CO-heteroaryl; CO—NH-alkylenearyl; CO—NH-aryl substituted with alkyl, alkoxy, halogen, CN, CF3; CO—NH-alkylenearyl substituted with alkyl, alkoxy, halogen, CN, CF3; CO—NH-heteroaryl; SO2—NH2; or; R1 and R2 together form a 5 or 6-membered ring which may optionally contain from 1 to 2 heteroatoms independently selected from the group consisting of nitrogen, oxygen and sulfur; and which may optionally bear 1 or 2 double bonds; and which may also be substituted by alkyl, halogenalkyl, aryl unsubstituted or substituted with alkyl, alkoxy, hydroxy, halogen, CN, CF3, and/or heteroaryl; and which may also contain a carbonyl group; and which may also be condensed with aryl; R3 and R4 are independently selected from the group consisting of H, alkyl, cycloalkyl; or R3 and R4 together form a ring selected from the group consisting of pyrrolidinyl, piperidinyl-p-phenyl, piperazinyl-p-phenyl and morpholino.
In a particularly preferred embodiment of the present invention, R1 is only H if R2 does not contain a CO group.
In another particularly preferred embodiment of the present invention, R3 and R4 are both H.
Where in the compounds of Formula I or in other compounds described within the scope of the present invention substituents are or contain alkyl, cycloalkyl, alkylene, alkoxy, these may each be straight-chain or branched and possess 1 to 8, preferably 1 to 6 and more preferably 1 to 4 carbon atoms. Suitable are methyl, ethyl, propyl, iso-propyl, butyl, isobutyl, tert.-butyl, cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, methylene, ethylene, propylene, iso-propylene, butylenes, iso-butylene, tert-butylene, methoxy, ethoxy, propoxy, iso-propoxy, butoxy, iso-butoxy, and tert.-butoxy.
Where substituents in compounds of Formula I stand for halogen, fluorine, chlorine, bromine or iodine are suitable. Chlorine and bromine are preferred.
Where substituents in compounds of Formula I stand for aryl single aromatic ring systems with an adequate number of hydrogen atoms dependent upon the substitution pattern are meant. However, condensed and spiro aryl systems are also included in this definition. Suitable aryl substituents are phenyl, 1H-indene, 9H-fluorene, naphthalene, anthracene, and phenathrene.
Where substituents in compounds of Formula I stand for heteroaryl, aryl ring systems are meant wherein one or more carbon atoms from the aromatic ring system are replaced by a heteroatom selected from the group consisting of oxygen, nitrogen and sulfur. Suitable heteroaryls are pyrrol, furane, thiophene, indolizine, indole, isoindole, cumarone, thionaphthene, pyrozole, imidozole, oxazole, isooxazole, thiazole, isothiazole, triazole, tetrazole, thiadiazole, pyridine, pyrane, thiopyrane, chinoline, isochinoline, pyridazine, pyrimidine, pyrazine, and triazine.
Physiologically compatible acid addition salts of compounds of Formula I are their conventional salts with inorganic acids, for example sulfuric acid, phosphoric acids or hydrohalic acids, preferably hydrochloric acid, or with organic acids, for example lower aliphatic monocarboxylic, dicarboxylic or tricarboxylic acids such as maleic acid, fumaric acid, lactic acid, tartaric acid, citric acid, or with sulfonic acids, for example lower alkanesulfonic acids such as methanesulfonic acid or trifluoromethanesulfonic acid, or benzenesulfonic acids optionally substituted in the benzene ring by halogen or lower alkyl, such as p-toluenesulfonic acid. Hydrochloric acid salts of the compounds of Formula I are preferred.
Compounds of Formula I, wherein R3 and R4 are both not H, and their physiologically acceptable acid addition salts can be prepared by reacting a compound of Formula II
with a sulfamoylchloride of Formula III,
to give compound of Formula IV

Compounds of Formula IV are then reacted with an amine H2NR1 to give compounds of Formula V

Compounds of Formula V are further reacted with R2X wherein X is selected from the group consisting of Cl, Br, and I, to give compounds of Formula I

Alternatively, compounds of Formula I wherein R3 and R4 are both not H, can be prepared by reacting compounds of Formula IV with an amine HNR1R2 to give compounds of Formula I

Compounds of Formula I wherein R3 and R4 are both H, can be prepared by reacting a compound of Formula II
with sulfamoylchloride, which is protected with a protecting group PG, preferably tert.-butyloxycarbonyl or benzyl, of Formula VIa, or with the reagent of Formula VIb,
to give a compound of formula VII

Compounds of Formula VII are then reacted with an amine H2NR1 to give compounds of Formula VIII

Compounds of Formula VIII are further reacted with R2X wherein X is selected from the group consisting of Cl, Br, and I, to give compounds of Formula IX
and subsequently cleaving off the protecting group PG under suitable conditions from the obtained intermediate products, then leads to compounds of Formula I wherein R3 and R4 both H. If the protecting group is tert.-butyloxycarbonyl, then the removal of PG can be achieved under acidic conditions, preferably in the presence of hydrogen chloride. If the protecting group is benzyl, then the removal of PG can be achieved with hydrogenation, preferably in the presence of hydrogen and a catalyst, such as Pd.
Alternatively, compounds of Formula I wherein R3 and R4 are both H, can be prepared by reacting a compound of Formula VII with an amine HNR1R2 to give compounds of Formula IX
and subsequently cleaving off the protecting group PG under suitable conditions from the obtained intermediate products, then leads to compounds of Formula I wherein R3 and R4 both H. If the protecting group is tert.-butyloxycarbonyl, then the removal of PG can be achieved under acidic conditions, preferably in the presence of hydrogen chloride. If the protecting group is benzyl, then the removal of PG can be achieved with hydrogenation, preferably in the presence of hydrogen and a catalyst, such as Pd.
Compounds of Formula I wherein R2 contains a methylene spacer CH2, can be prepared by reacting a compound of Formula X
with a protecting agent PG, to give a compound of formula XI

Compounds of Formula XI are then reacted with an aldehyde R2′-CHO, to give compounds of Formula XII,
wherein R2′ is selected from the group consisting of alkyl; cycloalkyl; alkylenearyl, unsubstituted or substituted, but not substituted by furan or furanyl; alkylenealkoxy; and alkylenecycloalkyl;
Then, the protecting group PG of compounds of Formula XII is cleaved off under suitable conditions and the unprotected compound is then reacted with sulfamoylchloride ClSO2—NH2 to give compounds of Formula I. If the protecting group is tert.-butyloxycarbonyl, then the removal of PG can be achieved under acidic conditions, preferably in the presence of hydrogen chloride. If the protecting group is benzyl, then the removal of PG can be achieved with hydrogenation, preferably in the presence of hydrogen and a catalyst, such as Pd.
Alternatively, compounds of Formula I wherein R2 contains a methylene spacer CH2, can be prepared by cleaving off the protecting group PG of compounds of Formula XII under suitable conditions and the then unprotected compound is reacted with sulfamoylchloride, which is protected with a protecting group PG, preferably tert.-butyloxycarbonyl or benzyl, of Formula VIa, or with the reagent of Formula VIb,
to give a compound of formula XIII
and subsequently cleaving off the protecting group PG under suitable conditions from the obtained intermediate product, then leads to compounds of Formula I wherein R3 and R4 both H. If the protecting group is tert.-butyloxycarbonyl, then the removal of PG can be achieved under acidic conditions, preferably in the presence of hydrogen chloride. If the protecting group is benzyl, then the removal of PG can be achieved with hydrogenation, preferably in the presence of hydrogen and a catalyst, such as Pd.
In another alternative, compounds of Formula I wherein R2 contains a methylene spacer CH2, can be prepared by reacting a compound of Formula X
with a protecting agent PG, to give a compound of formula XI

Compounds of Formula XI are then reacted with a ketone R2′-COR1′, to give compounds of Formula XIV,
wherein R1′ is selected from the group consisting of alkyl; alkylenealkoxy; alkylenecycloalkyl; alkylenearyl; alkylenearylenealkyl; alkylenearylenehalogen; alkylenearyleneoxyalkyl, alkylenearylenedialkylamin; and alkyleneheteroaryl unsubstituted or substituted with alkyl, alkoxy, halogen, CN, CF3;
wherein R2′ is selected from the group consisting of alkyl; cycloalkyl; alkylenearyl, unsubstituted or substituted, but not substituted by furan or furanyl; alkylenealkoxy; and alkylenecycloalkyl;
The protecting group PG of compounds of Formula XIV is then cleaved off under suitable conditions and the then unprotected compound is reacted with sulfamoylchloride, which is protected with a protecting group PG, preferably tert.-butyloxycarbonyl or benzyl, of Formula VIa, or with the reagent of Formula VIb,
to give a compound of formula XV
and subsequently cleaving off the protecting group PG under suitable conditions from the obtained intermediate product, then leads to compounds of Formula I wherein R3 and R4 both H. If the protecting group is tert.-butyloxycarbonyl, then the removal of PG can be achieved under acidic conditions, preferably in the presence of hydrogen chloride. If the protecting group is benzyl, then the removal of PG can be achieved with hydrogenation, preferably in the presence of hydrogen and a catalyst, such as Pd.
Compounds of Formula I can also be prepared by reacting a compound of Formula II
with a protecting agent PG to give a compound of formula XVII

Compounds of Formula XVII are then reacted with an amine NHR1R2 to give compounds of Formula XVIII,

The protecting group PG of compounds of Formula XVIII is then cleaved off under suitable, conditions and the then unprotected compound is reacted with sulfamide to give compounds of Formula I, or with a compound of formula III to give compounds of Formula I, or with a compound of formulae VIa or VIb to give a compound of formula XIX
and subsequently cleaving off the protecting group PG under suitable conditions from the obtained intermediate product, then leads to compounds of Formula I. If the protecting group is tert.-butyloxycarbonyl, then the removal of PG can be achieved under acidic conditions, preferably in the presence of hydrogen chloride. If the protecting group is benzyl, then the removal of PG can be achieved with hydrogenation, preferably in the presence of hydrogen and a catalyst, such as Pd.
In another embodiment compounds of Formula I are prepared by reacting a compound of Formula VXIIIa wherein R1 is H
with a compound of formula XXR5-N═C═O  XX
wherein R5 is selected from the group consisting of alkyl; cycloalkyl; aryl substituted with alkyl, alkoxy, halogen, CN, CF3; alkylenearyl unsubstituted or substituted with alkyl, alkoxy, halogen, CN, CF3; and heteroaryl; to give a compound of formula XXI

The protecting group PG of compounds of Formula XXI is then cleaved off under suitable conditions and wherein the unprotected compound is then reacted with sulfamide to give compounds of Formula I, or with a compound of formula III to give compounds of Formula I, or with a compound of formulae VIa or VIb to give a compound of formula XXII
and subsequently cleaving off the protecting group PG under suitable conditions from the obtained intermediate product, then leads to compounds of Formula I. If the protecting group is tert.-butyloxycarbonyl, then the removal of PG can be achieved under acidic conditions, preferably in the presence of hydrogen chloride. If the protecting group is benzyl, then the removal of PG can be achieved with hydrogenation, preferably in the presence of hydrogen and a catalyst, such as Pd.
Compounds of Formula I can alternatively also be prepared by reacting a compound of Formula VXIIIa wherein R1 is H
with a compound of formula XXIII
wherein R6 is selected from the group consisting of alkyl; aryl unsubstiuted or substituted by alkyl, alkoxy, halogen, CF3, CN; to give a compound of formula XXIV

The protecting group PG of compounds of Formula XXIV is then cleaved off under suitable conditions and wherein the unprotected compound is then reacted with sulfamide to give compounds of Formula I, or with a compound of formula III to give compounds of Formula I, or with a compound of formulae VIa or VIb to give a compound of formula XXV
and subsequently cleaving off the protecting group PG under suitable conditions from the obtained intermediate product, to give compounds of formula I. If the protecting group is tert.-butyloxycarbonyl, then the removal of PG can be achieved under acidic conditions, preferably in the presence of hydrogen chloride. If the protecting group is benzyl, then the removal of PG can be achieved with hydrogenation, preferably in the presence of hydrogen and a catalyst, such as Pd.
In another embodiment of the present invention, compounds of Formula I can be prepared by reacting a compound of Formula XI
with a compound of formula XXIII to give compounds of Formula XXVI

The protecting group PG of compounds of Formula XXVI is then cleaved off under suitable conditions and wherein the unprotected compound is then reacted with sulfamide to give compounds of Formula I, or with a compound of formula III to give compounds of Formula I, or with a compound of formulae VIa or VIb to give a compound of formula XXVII
and subsequently cleaving off the protecting group PG under suitable conditions from the obtained intermediate product, to give compounds of formula I. If the protecting group is tert.-butyloxycarbonyl, then the removal of PG can be achieved under acidic conditions, preferably in the presence of hydrogen chloride. If the protecting group is benzyl, then the removal of PG can be achieved with hydrogenation, preferably in the presence of hydrogen and a catalyst, such as Pd.
In another embodiment of the present invention, compounds of Formula I can be prepared by reacting a compound of Formula VIII
with compounds of formula XXR5-N═C═O  XXto give compounds of Formula XXVIII

The protecting group PG of compounds of Formula XXVIII is then cleaved off under suitable conditions to give compounds of Formula I. If the protecting group is tert.-butyloxycarbonyl, then the removal of PG can be achieved under acidic conditions, preferably in the presence of hydrogen chloride. If the protecting group is benzyl, then the removal of PG can be achieved with hydrogenation, preferably in the presence of hydrogen and a catalyst, such as Pd.
In another embodiment of the present invention, compounds of Formula I can be prepared by reacting a compound of Formula XI
with compounds of formula XXIX
to give compounds of Formula XXX

The protecting group PG of compounds of Formula XXX is then cleaved off under suitable conditions to give compounds of Formula XXXI

Further on, the compound of Formula XXXI is then reacted with sulfamoylchlorid of Formula III to give compounds of Formula I, or the compound of Formula XXXI is then reacted with a compound of Formulae VIa or VIb to give a compound of Formula XXXII

The protecting group PG of compounds of Formula XXXII is then cleaved off under suitable conditions to give compounds of Formula I. If the protecting group is tert.-butyloxycarbonyl, then the removal of PG can be achieved under acidic conditions, preferably in the presence of hydrogen chloride. If the protecting group is benzyl, then the removal of PG can be achieved with hydrogenation, preferably in the presence of hydrogen and a catalyst, such as Pd.
If desired, the resulting free bases of compounds of Formula I independently of their substitution pattern at R3 and R4 can be converted into their physiologically acceptable acid addition salts, or, the resulting acid addition salts of the compounds of Formula I independently of their substitution pattern at R3 and R4, can be converted into the free bases of Formula I.
In yet another aspect, the present invention also relates to a method of treating or preventing glaucoma, epilepsy, bipolar disorders, migraine, neuropathic pain, obesity, type II diabetes, metabolic syndrome, alcohol dependence, and/or cancer, and its concomitant and/or secondary diseases or conditions in mammals and humans, comprising administering to a subject in need thereof a therapeutically effective amount of a compound of Formula I or its physiologically compatible acid addition salts.
Obesity according to the present invention is meant to comprise any increase in body fat that results in increased bodyweight, comprising as a preferred alternative but not limited to the medical definition of obesity. The invention thus also relates to non-medical weight loss, such as cosmetic weight loss and includes improving bodily appearance in general. Further, the term obesity also is meant to comprise drug induced obesity and/or juvenile obesity.
The concomitant diseases of obesity and its concomitant and/or secondary diseases or conditions in mammals and humans according to the invention include in particular the metabolic syndrome and/or syndrome X and cardiovascular diseases.
The term “metabolic syndrome” as used in this application is meant to cover a complex of clinical pictures which—besides central obesity—mainly comprises hypertension, in particular arterial hypertension; insulin resistance, in particular diabetes mellitus type II; glucose intolerance; dyslipoproteinaemia, in particular as hypertriglyceridaemia, accompanied by dyslipoproteinaemia occurring with lowered HDL-cholesterol, and also hyperuricaemia, which can lead to gout. According to information from the American Heart Association, the metabolic syndrome is closely linked to insulin resistance. Some people are genetically predisposed to insulin resistance. Acquired factors, such as excess body fat and physical inactivity, can elicit insulin resistance and the metabolic syndrome in these people. Most people with insulin resistance have central obesity. The biologic mechanisms at the molecular level between insulin resistance and metabolic risk factors are not fully understood and appear to be complex. One group of people at risk for developing metabolic syndrome are those with diabetes who have a defect in insulin action and cannot maintain a proper level of glucose in their blood. Another is people, mainly those with high blood pressure, who are nondiabetic and insulin-resistant but who compensate by secreting large amounts of insulin. This condition is known as hyperinsulinemia. A third group is heart attack survivors who, unlike hypertensives, have hyperinsulinemia without having abnormal glucose levels. The metabolic syndrome has become increasingly common in higher developed countries like the United States, where it is estimated that about 20-25 percent of US adults have it. There are no well-accepted criteria for diagnosing the metabolic syndrome.
The criteria proposed by the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) are the most current and widely used. According to the ATP III criteria, the metabolic syndrome is identified by the presence of three or more of these components:                Central obesity as measured by waist circumference (Men—Greater than 40 inches; Women—Greater than 35 inches).        Fasting blood triglycerides greater than or equal to 150 mg/dL.        Blood HDL cholesterol (Men—Less than 40 mg/dL; Women—Less than 50 mg/dL)        Blood pressure greater than or equal to 130/85 mmHg.        Fasting glucose greater than or equal to 110 mg/dL.        
The term “syndrome X” is closely related to the term “metabolic syndrome” and usually is supposed to denominate the identical disease or condition. According to information from the American Heart Association, the term “Syndrome X” refers, however, additionally to a heart condition where chest pain and electrocardiographic changes that suggest ischemic heart disease are present, but where there are no angiographic findings of coronary disease. Patients with cardiac syndrome X also sometimes have lipid abnormalities.
The term “cardiovascular diseases” in conjunction with obesity is usually understood to mean coronary heart disease, which can lead to heart failure, cerebrovascular diseases, which may for example be accompanied by an increased risk of strokes, and peripheral occlusive arterial disease.
Due to their inherent properties, the compounds of Formula I or their physiologically compatible acid addition salts are also expected to be useful in the treatment of diabetic conditions or diseases which are unrelated to obesity. Such diabetic conditions or diseases comprise e.g. diabetes mellitus type II, diabetic neuropathy, diabetic retinopathy, diabetic nephropathy, diabetic microangiopathy or diabetic macroangiopathy.
Further concomitant and/or secondary diseases of obesity may be gall-bladder diseases such as formation of gallstones, sleep apnoea syndrome, orthopaedic complications such as osteoarthritis and psychosocial disorders.
The compounds of Formula I are further deemed to be useful as anticonvulsants for the prophylaxis or treatment of epilepsy in mammals and humans.
The compounds of Formula I according to the invention are inhibitors of mammalian carbonic anhydrases, in particular of human carbonic anhydrase isozymes of subtypes II and/or V (=hCA II and/or hCA V).
Pharmacological Test Methods
The example numbers quoted in the pharmacological test methods relate to the preparation examples described below.
1. In Vitro Inhibition of Human Carbonic Anhydrase Isoenzyme II (hCA II)
The test compounds of Formula I in 96 well microplates were diluted with aqua bidest by using an automatic pipettor (CyBiWell®). From the different dilution plates, aliquots of 20 μl were transferred to the 96 well black assay plates with a pipetting station (Tecan Genesis®). In a second step, 148 μl of potassium phosphate buffer (20 mM, pH 7.4) was added, and as a third step, 20 μl of enzyme solution (1 μM human carbonic anhydrase isoenzyme II from erythrocytes (Sigma-Aldrich), dissolved in potassium phosphate buffer) incubated for 60 min at room temperature and the fluorescence signal (Tecan Ultra® fluorescence reader; excitation wavelength: 280 nm; emission wavelength: 465 nm) read at the end of the preincubation period (FLU-1). After the preincubation time, 20 μl of aqueous dansylamide solution (1 mM dansylamide (Sigma-Aldrich), dissolved in hydrochloric acid) were added and the fluorescence signal read every 10 min for a period of 60 min at 37° C. For calculation, the fluorescence data of the time point 60 min (FLU-2) were used. The total volume of assay mixture amounted to 208 μl. The final concentration of carbonic anhydrase II was 10−7 M/L, of dansylamide 2.25×10−6 and of compounds from 10−8 M/L up to 10−5 M/L. Final concentration of DMSO as compound solvent was 0.1 mM. Each microplate also contained blanks without compound and enzyme, controls without compound and ethoxzolamide (final concentration 5×10−8 M/L). All data reflect single measurements. Data were expression as % inhibition after calculation by the formula:% inhibition=100((1−(FLU-2cpd−FLU-2blank−FLU-1cpd+FLU-1blank)/(FLU-2control−FLU-2blank-FLU-1control−FLU-1blank))
The % inhibiton data for each compound and the respective final concentration were used for IC50 calculations by using the Prism 4 software. Concentration action figures were calculated by applying the Prism algorithm for nonlinear regression (curve-fit): sigmoidal dose response with variable slope and the constraints: top: 100 and bottom 0.
In this test substances of Formula I listed in Table 1 below showed the IC50 values given below:
TABLE 1hCA II inhibiting effect of the test substances in vitroExample No.IC50 [μM]97.2107.3116.5286.62. Acute In Vivo Food Intake Test in Mice
The studies were carried out in male or female C57B1/6 mice (n=8-12 per group). The mice were kept on an inverted 12/12h light/dark cycle (lights on 22:00). They were allowed food (high caloric diet) and water ad libitum. Food intake and water consumption was measured daily. The test compound of Formula I was suspended in 1% methylcellulose in water and 2% (v/v) of Poloxamer 188 (Lutrol F68®) and administered by oral gavage at a dose of 100 mg/kg/day. One half of the dose was administered at 7.00-9.00 h; the remaining half of the dose was administered between 15.00-15.30 h.
In the test model described above, the test substances caused a decrease of the animals' 24 h food intake to the percentages of food intake when compared to control as given in the following Table 2.
TABLE 2Influence of test substances on food intakefood intakeExample No.[% of control]183178419932663
The present invention further provides a pharmaceutical composition or medicament comprising a pharmacologically effective quantity of a compound of Formula I or its physiologically compatible acid addition salts and further comprising conventional pharmaceutically acceptable auxiliaries
Suitable pharmaceutically acceptable auxiliaries and/or carriers are well know in the art and include pharmaceutical grade starch, mannitol, lactose, magnesium stearate, sodium saccharin, talcum, cellulose, glucose, sucrose (or other sugar), magnesium carbonate, gelatin, oil, alcohol, detergents, emulsifiers or water (preferably sterile). The composition may be a mixed preparation of a composition or may be a combined preparation for simultaneous, separate or sequential use (including administration). The compounds according to the invention or their physiologically compatible acid additions salts for use in the aforementioned indications may be administered by any convenient method, for example by oral (including by inhalation), parenteral, mucosal (e.g. buccal, sublingual, nasal), rectal or transdermal administration and the compositions adapted accordingly. For oral administration, the compounds can be formulated as liquids or solids, for example solutions, syrups, suspensions or emulsions, tablets, capsules and lozenges. A liquid formulation will generally consist of a suspension or solution of the compound or physiologically acceptable salt in a suitable aqueous or non-aqueous liquid carrier(s) for example water, ethanol, glycerine, polyethylene glycol or an oil.
The formulation may also contain a suspending agent, preservative, flavouring or coloring agent. A composition in the form of a tablet can be prepared using any suitable pharmaceutical carrier(s) routinely used for preparing solid formulations. Examples of such carriers include magnesium stearate, starch, lactose, sucrose and microcrystalline cellulose. A composition in the form of a capsule can be prepared using routine encapsulation procedures. For example, powders, granules or pellets containing the active ingredient can be prepared using standard carriers and then filled into a hard gelatin capsule; alternatively, a dispersion or suspension can be prepared using any suitable pharmaceutical carrier(s), for example aqueous gums, celluloses, silicates or oils and the dispersion or suspension then filled into a soft gelatin capsule. Compositions for oral administration may be designed to protect the active ingredient against degradation as it passes through the alimentary tract, for example by an outer coating of the formulation on a tablet or capsule. Typical parenteral compositions consist of a solution or suspension of the compound or physiologically compatible acid addition salts in a sterile aqueous or non-aqueous carrier or parenterally acceptable oil, for example polyethylene glycol, polyvinyl pyrrolidone, lecithin, arachis oil or sesame oil. Alternatively, the solution can be lyophilized and then reconstituted with a suitable solvent just prior to administration. Compositions for nasal or oral administration may conveniently be formulated as aerosols, drops, gels and powders.
Aerosol formulations typically comprise a solution or fine suspension of the active substance in a physiologically acceptable aqueous or non-aqueous solvent and are usually presented in single or multidose quantities in sterile form in a sealed container, which can take the form of a cartridge or refill for use with an atomising device. Alternatively the sealed container may be a unitary dispensing device such as a single dose nasal inhaler or an aerosol dispenser fitted with a metering valve which is intended for disposal once the contents of the container have been exhausted. Where the dosage form comprises an aerosol dispenser, it will contain a pharmaceutically acceptable propellant. The aerosol dosage forms can also take the form of a pump-atomiser. Compositions suitable for buccal or sublingual administration include tablets, lozenges and pastilles, wherein the active ingredient is formulated with a carrier such as sugar and acacia, tragacanth, or gelatin and glycerin. Compositions for rectal or vaginal administration are conveniently in the form of suppositories (containing a conventional suppository base such as cocoa butter), pessaries, vaginal tabs, foams or enemas. Compositions suitable for transdermal administration include ointments, gels, patches and injections including powder injections. Conveniently the composition is in unit dose form such as a tablet, capsule or ampoule. The pharmaceutical compositions according to the invention are useful in the prevention and/or treatment of obesity, concomitant and/or secondary diseases of obesity; other medical weight loss and non-medical related weight loss; and/or diabetic conditions or diseases.
The compounds of the present invention and their physiologically compatible acid addition salts are generally administered as pharmaceutical compositions which are important and novel embodiments of the invention because of the presence of the compounds disclosed herein. In embodiments of the invention, a pharmaceutical pack or kit is provided comprising one or more container(s) filled with one or more of the ingredients of a pharmaceutical composition of the invention. Associated with such container(s) can be various written materials such as instructions for use, or a notice in the form prescribed by a governmental agency regulating the manufacture, use or sale of pharmaceuticals products, which notice reflects approval by the agency of manufacture, use, or sale for human or veterinary administration.
Yet a further aspect of the invention provides a process for the manufacture of a pharmaceutical composition as described hereabove. The manufacture can be carried out by standard techniques well known in the art and involves combining a compound according to the invention and the pharmaceutically acceptable auxiliaries and/or carriers. The composition may be in any form including a tablet, a liquid, a capsule, and a powder or in the form of a food product, e.g. a functional food. In the latter case the food product itself may act as the pharmaceutically acceptable carrier.
The compound or composition is preferably administered to a patient in need thereof and in a quantity sufficient to prevent and/or treat the symptoms of the condition, disorder or disease. For all aspects of the invention, particularly medical ones, the administration of a compound or composition has a dosage regime which will ultimately be determined by the attending physician and will take into consideration such factors such as the compound being used, animal type, age, weight, severity of symptoms, method of administration, adverse reactions and/or other contraindications. Specific defined dosage ranges can be determined by standard design clinical trials with patient progress and recovery being fully monitored. Such trials may use an escalating dose design using a low percentage of the maximum tolerated dose in animals as the starting dose in man. The physiologically acceptable compounds of the invention will normally be administered in a daily dosage regimen (for an adult patient) of, for example, an oral dose of between 1 mg and 2000 mg, preferably between 30 mg and 1000 mg, e.g. between 10 and 250 mg or an intravenous, subcutaneous, or intramuscular dose of between 0.1 mg and 100 mg, preferably between 0.1 mg and 50 mg, e.g. between 1 and 25 mg of the compound of the Formula I or a physiologically acceptable salt thereof calculated as the free base, the compound being administered 1 to 4 times per day. The compound used according to the invention can also be administered to children or juveniles while the individual dosage regimens in these cases will need to be particularly thoroughly adjusted by the physician and will usually comprise lower doses than will be administered to adults.
Suitably the compounds will be administered for a period of continuous therapy, for example for at least a week, but usually for a longer period of several weeks to several months. The invention also provides a cosmetic method (non-therapeutic) for maintaining a given weight, or for cosmetic weight loss, the method comprising the administration of a compound according to the other aspects of the invention, preferably in combination with a pharmaceutically acceptable carrier or diluent.
The compound or composition is preferably administered to a subject in need or in desideratum thereof and in a quantity sufficient to maintain a given weight or for cosmetic weight loss.
In still a further aspect, the compounds of Formula I and their physiologically compatible acid addition salts may favourably be administered in combination with one or more active agents (as a pharmaceutical combination composition) selected from antidiabetics; antiobesity or appetite-regulating agents; cardiovascular active agents, in particular antihypertensives; diuretics; active agents altering lipid levels, in particular lipid-lowering agents; and active ingredients for the treatment and/or prevention of complications caused by diabetes or associated with diabetes.
Suitable antidiabetics comprise e.g. insulins, amylin, derivatives of GLP-1 and GLP-2 such as, for example, those disclosed in WO 98/08871 and orally active hypoglycemic active ingredients. The orally active hypoglycemic active ingredients preferably comprise sulfonylureas, e.g tolbutamide, glibenclamide, glimepiride, glipizide, gliquidone, glisoxepide, glibomuride or gliclazide; biguanides, e.g. metformin; meglitinides, e.g. repaglinide; beta3 adrenergic agonists; oxadiazolidinediones; glucosidase inhibitors e.g. alpha-glucosidase inhibitors such as miglitol or acarbose; glucagon receptor antagonists, GLP-1 agonists, potassium channel openers like diazoxide or those disclosed in WO 97/26265 or WO 99/03861; CB-1 (cannabinoid-1 receptor) antagonists/inverse agonists; insulin sensitizers like thiazolidinediones, e.g. troglitazone, ciglitazone, pioglitazone, rosiglitazone or the compounds disclosed in WO 97/41097, in particular 5-[[4-[(3,4-dihydro-3-methyl-4-oxo-2-quinazolinylmethoxy]pheny-1]methyl]-2,4-thiazolidine dione; activators of insulin receptor kinase; inhibitors of liver enzymes involved in the stimulation of gluconeogenesis and/or glycogenolysis, for example inhibitors of glycogen phosphorylase; and modulators of glucose uptake and glucose excretion.
Suitable antiobesity or appetite-regulating agents comprise one or more of a 5-HT (serotonin) transporter inhibitor, a NE (norepinephrine) transporter inhibitor, a CB-1 (cannabinoid-1 receptor) antagonist/inverse agonist, a ghrelin antibody, a ghrelin antagonist, a H3 (histamine H3) antagonist/inverse agonist, a MCH1R (melanin concentrating hormone 1R) antagonist, a MCH2R (melanin concentrating hormone 2R) agonist/antagonist, a NPY1 (neuropeptide Y Y1) antagonist, a NPY2 (neuropeptide Y Y2) agonist, a NPY5 (neuropeptide Y Y5) antagonist, leptin, a leptin derivative, an opioid antagonist, an orexin antagonist, a BRS3 (bombesin receptor subtype 3) agonist, a CCK-A (cholecystokinin-A) agonist, a CNTF (ciliary neurotrophic factor), a CNTF derivative, a GHS (growth hormone secretagogue receptor) agonist, SHT2c (serotonin receptor 2c) agonist, a Mc3r (melanocortin 3 receptor) agonist, a Mc4r (melanocortin 4 receptor) agonist, a monoamine reuptake inhibitor, a serotonin reuptake inhibitor, a GLP-1 (glucagon-like peptide 1) agonist, topiramate, phytopharm compound 57, an ACC2 (acetyl-CoA carboxylase-2) inhibitor, a beta3 adrenergic agonist, a DGAT1 (diacylglycerol acyltransferase 1) inhibitor, a DGAT2 (diacylglycerol acyltransferase 2) inhibitor, a FAS (fatty acid synthase) inhibitor, a PDE (phosphodiesterase) inhibitor, a thyroid hormone B agonist, an UCP-1 (uncoupling protein 1), 2, or 3 activator, an acyl-estrogen, a glucocorticoid antagonist, an 11 HSD-1 (11-beta hydroxy steroid dehydrogenase type 1) inhibitor, a SCD-1 (stearoyl-CoA desaturase-1) inhibitor, a dipeptidyl peptidase IV (DP-IV) inhibitor, a lipase inhibitor, a fatty acid transporter inhibitor, a dicarboxylate transporter inhibitor, a glucose transporter inhibitor, a phosphate transporter inhibitor, and pharmaceutically acceptable salts and esters thereof.
Suitable appetite-regulating agents (appetite suppressants) comprise sibutramine or the mono- and bisdemethylated active metabolites of sibutramine; fenfluramine or dexfenfluramine; mazindol, diethylpropion or phentermine; leptin or modified leptin; dexamphetamine and amphetamine.
Suitable lipase inhibitors comprise orlistat, panclicins, lipase inhibitors isolated from micro organisms such as lipstatin (from Streptomyces toxytricini), ebelactone B (from Streptomyces aburaviensis), synthetic derivatives of these compounds; 2-oxy-4H-3,1-benzoxazin-4-one derivatives like Alizyme's ATL-962 or structurally related compounds; 2-amino-4H-3,1-benzoxazin-4-one derivatives or extracts of plants known to possess lipase inhibitory activity, e.g. extracts of Alpinia officinarum or compounds isolated from such extracts like 3-methylethergalangin (from A. officinarum);
Suitable CB1-cannabinoid antagonists include rimonabant, SLV319, SR147778 and CP-945598.
Suitable cardiovascular active agents comprise angiotensin II receptor antagonists, e.g. abitesartan, benzyllosartan, candesartan, elisartan, embusartan, enoltasosartan, eprosartan, fonsartan, forasartan, glycyllosartan, irbesartan, isoteoline, losartan, milfasartan, olmesartan, opomisartan, pratosartan, ripisartan, saprisartan, saralasin, sarmesin, tasosartan, telmisartan, valsartan, zolasartan; Kissei KRH-94, Lusofarmaco LR-B/057, Lusofarmaco LR-B/081, Lusofarmaco LR B/087, Searle SC-52458, Sankyo CS-866, Takeda TAK-536, Uriach UR-7247, A-81282, A-81988, BIBR-363, BIBS39, BIBS-222, BMS-180560, BMS-184698, CGP-38560A, CGP-48369, CGP-49870, CGP-63170, CI-996, CV-11194, DA-2079, DE-3489, DMP-811, DuP-167, DuP-532, GA-0056, E-4177, EMD-66397, EMD-73495, EXP-063, EXP-929, EXP-3174, EXP-6155, EXP-6803, EXP-7711, EXP-9270, FK-739, HN-65021, HR-720, ICI-D6888, ICI-D7155, ICI-D8731, KRI-1177, KT3-671, KW-3433, L-158809, L-158978, L-159282, L-159689, L-159874, L-161177, L-162154, L-162234, L-162441, L-163007, L-163017, LY-235656, LY-285434, LY-301875, LY-302289, LY-315995, ME-3221, PD-123177, PD-123319, PD-150304, RG-13647, RWJ-38970, RWJ-46458, S-8307, S-8308, SL-91.0102, U-96849, U-97018, UP-269-6, UP-275-22, WAY-126227, WK-1492.2K, WK-1360, X-6803, XH-148, XR-510, YM-358, YM-31472, ZD-6888, ZD-7155 and ZD-8731 or any physiologically compatible salts, solvates, prodrugs or esters thereof; daglutril; non-selective alpha-adrenoceptor antagonists, e.g. tolazoline or phenoxybenzamine; selective alpha-adrenoceptor antagonists, e.g. doxazosin, prazosin, terazosin or urapidil; beta-adrenoceptor antagonists, e.g. acebutolol, alprenolol, atenolol, betaxolol, bisoprolol, bupranolol, carazolol, carteolol, celiprolol, mepindolol, metipranolol, metoprolol, nadolol, oxprenolol, penbutolol, pindolol, propranolol, sotalol and timolol; mixed antagonists of alpha- and beta-adrenoceptors, e.g. carvedilol or labetolol; ganglion blockers, e.g. reserpine or guanethidine; alpha2-adrenoceptor agonists (including centrally acting alpha2-adrenoceptor agonists), e.g. clonidine, guanfacine, guanabenz methyldopa and moxonidine; renin-inhibitors, e.g. alskiren; ACE-inhibitors, e.g. benazepril, captopril, cilazapril, enalapril, fosinopril, imidapril, lisinopril, moexipril, quinapril, perindopril, ramipril, spirapril or trandolapril; mixed or selective endothelin receptor antagonists e.g. atrasentan, bosentan, clazosentan, darusentan, sitaxsentan, tezosentan, BMS-193884 or J-104132; direct vasodilators, e.g. diazoxide, dihydralazine, hydralazine or minoxidil; mixed ACE/NEP-inhibitors, e.g. omapatrilat; ECE-inhibitors, e.g. FR-901533; PD-069185; CGS-26303; CGS-34043; CGS-35066; CGS-30084; CGS-35066; SM-19712; Ro0677447; selective NEP-inhibitors; vasopressin antagonists, aldosterone receptor antagonists, e.g. eplerenone or spironolactone; angiotensin vaccine; and urotensin II receptor antagonists.
Suitable diuretics comprise thiazide diuretics, e.g. althiazide, bemetizide, bendroflumethiazide, benzylhydrochlorothiazide, benzthiazide, buthiazide, chlorothiazide, cyclothiazide, hydrochlorothiazide, hydroflumethiazide, methyclothiazide, paraflutizide, polythiazide, teclothiazide, trichlormethiazide; thiazide analog diuretics, e.g. chloraminofenamide, chlortalidone, clofenamide, clopamide, clorexolone, fenquizone, indapamide, mefruside, metolazone, quinethazone, tripamide, xipamide; loop diuretics, e.g. azosemide, bumetanide, furosemide, piretanide, torsemide; potassium sparing diuretics, e.g. amiloride, potassium canrenoate, spironolactone, triamterene or any physiologically compatible tautomers, salts, solvates, prodrugs or esters of any afore mentioned diuretic.
Suitable active agents which alter lipid levels comprise compounds which alter lipid metabolism, such as antihyperlipidemic active ingredients and antilipidemic active ingredients like HMGCoA reductase inhibitors, e.g. atorvastatin, berivastatin, cerivastatin, crilvastatin, fluvastatin, glenvastatin, lovastatin, mevastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin or any physiologically compatible salts, solvates, prodrugs or esters thereof; inhibitors of cholesterol transport/of cholesterol uptake; inhibitors of bile acid reabsorption or inhibitors of the microsomal triglyceride transfer protein (MTP); compounds which reduce food intake, PPAR (=peroxisome proliferator-activated receptors) and RXR agonists and active agents which act on the ATP-dependent potassium channel of the beta cells; fibric acids, e.g. bezafibrate, ciprofibrate, clofibrate, fenofibrate or gemfibrozil; cholestyramine, colestipol, probucol, ezetimibe and dextrothyroxine; HMGCoA synthase inhibitor, a cholesterol absorption inhibitor, an acyl coenzyme A-cholesterol acyl transferase (ACAT) inhibitor, a cholesteryl ester transfer protein (CETP) inhibitor, a squalene synthetase inhibitor, an anti-oxidant, a PPAR □ agonist, a FXR receptor modulator, a LXR receptor agonist, a lipoprotein synthesis inhibitor, a renin angiotensin system inhibitor, a microsomal triglyceride transport inhibitor, a bile acid reabsorption inhibitor, a PEAR8 agonist, a triglyceride synthesis inhibitor, a transcription modulator, a squalene epoxidase inhibitor, a low density lipoprotein receptor inducer, a platelet aggregation inhibitor, a 5-LO or FLAP inhibitor, a PPAR 8 partial agonist, and niacin or a niacin receptor agonist, and pharmaceutically acceptable salts and esters thereof.
Further active agents which may be suitable for use in combination with the compound of Formula I according to the present invention may be selected from the group consisting of CART agonists, H3 antagonists, TNF agonists, CRF agonists, CRF BP antagonists, urocortin agonists, beta3-agonists, MSH (melanocyte-stimulating hormone) agonists, serotonin-reuptake inhibitors, mixed serotonin- and noradrenaline-reuptake inhibitors, 5HT modulators, MAO inhibitors, galanin antagonists, growth hormone, growth hormone-releasing compounds, TRH agonists, modulators of uncoupling proteins 2 or 3, leptin agonists, dopamine agonists (bromocriptine, doprexin), RXR modulators, hCNTF agonists and TR-beta-agonists.
Preferred pharmaceutical combination compositions according to the invention comprise combinations of at least one compound of Formula I and at least one biguanide; at least one compound of Formula I and at least one fibric acid; at least one compound of Formula I and at least one HMGCoA reductase inhibitor; and at least one compound of Formula I and at least one insulin sensitizer.
Preferred compounds of Formula I for combination with one or more of the above mentioned active agents are 4-phenyl-piperazine-1-sulfonic acid amide; 4-(2-chloro-phenyl)-piperazine-1-sulfonic acid amide; 4-(2-methoxy-phenyl)-piperazine-1-sulfonic acid amide; 4-pyridin-4-yl-piperazine-1-sulfonic acid amide; 4-pyrimidin-2-yl-piperazine-1-sulfonic acid amide; 4-(4-fluoro-phenyl)-piperazine-1-sulfonic acid amide; 4-(4-chloro-3-trifluoromethyl-phenyl)-piperazine-1-sulfonic acid amide and/or 4-(3-chloro-5-trifluoromethyl-pyridin-2-yl)-piperazine-1-sulfonic acid amide.
Metformine is the preferred biguanide for combination with at least one compound of Formula I.
Preferred fibric acids for combination with at least one compound of Formula I are bezafibrate, ciprofibrate, clofibrate, fenofibrate and/or gemfibrozil. Fenofibrate is most preferred.
Preferred HMGCoA reductase inhibitors for combination with at least one compound of Formula I are atorvastatin, berivastatin, cerivastatin, crilvastatin, fluvastatin, glenvastatin, lovastatin, mevastatin, pitavastatin, pravastatin, rosuvastatin and/or simvastatin or any physiologically compatible salts, solvates, prodrugs or esters thereof. Most preferred are simvastatin, lovastatin and/or pravastatin.
Preferred insulin sensitizers for combination with at least one compound of Formula I are thiazolidinediones, in particular troglitazone, ciglitazone, pioglitazone and/or rosiglitazone. Rosiglitazone and pioglitazone are most preferred.
More preferred combinations according to the invention are the combinations of 4-phenyl-piperazine-1-sulfonic acid amide with metformine; 4-phenyl-piperazine-1-sulfonic acid amide with fenofibrate; 4-phenyl-piperazine-1-sulfonic acid amide with simvastatin and 4-phenyl-piperazine-1-sulfonic acid amide with rosiglitazone.
In one embodiment of the pharmaceutical combination compositions as described above and according to the invention, the compounds of Formula I can be obtained and administered together with the different active agents, e.g. in one combined unit dosage form like in one tablet or capsule, i.e. in a physical combination. In such a combined unit dosage form, the compound of Formula I and the different active agents can be segregated from each other, e.g. by means of different layers in said tablet, e.g. by using inert intermediate layers known in the art; or by using different compartments in the capsule. The corresponding active agents or their pharmaceutically acceptable salts may also be used in form of their hydrates or include other solvents used for crystallization. A unit dosage form may be a fixed combination. A unit dosage form, in particular a fixed combination of the compound of Formula I and one or more of the different active agents is a preferred alternative of this embodiment.
In another embodiment the compounds of Formula I and the different active agents can be obtained and administered in two or more separate unit dosage forms, e.g. in two or more tablets or capsules, the tablets or capsules being physically segregated from each other. The two or more separate unit dosage forms can be administered simultaneously or stepwise (separately), e.g. sequentially one after the other in either order. Thus, the compounds of Formula I and the different active agents can be administered in either order at the same time or at different times spread over the day, the optimal dosage regimen usually being determined by prescription of a physician.
The following examples are intended to explain the invention further, without limiting its scope.